Individual
JACQUELINE MILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
5224 S STATE HIGHWAY 360 STE 230, GRAND PRAIRIE, TX 75052-0964
(972) 522-0691
Mailing address
5224 S STATE HIGHWAY 360, GRAND PRAIRIE, TX 75052-0950
(972) 552-0691
(972) 522-1053
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
874631
TX
Other
Enumeration date
01/24/2020
Last updated
03/03/2020
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